Persistent Heart Pain: When to Seek Emergency Care

Persistent heart pounding?

Hello, Doctor! I have a history of atrial septal defect, but my heart has started to have recurrent issues.
It feels like my heart is having episodes; I've been experiencing sharp chest pains for three days now, lasting almost a minute each time.
The episodes occur sporadically from around 7 AM to the afternoon or evening.
I am sweating profusely and experiencing chest tightness, making it hard to breathe.
On March 10th, my doctor prescribed me three types of angina medications and advised me to take them during an episode.
I have almost finished the medication, but the pain continues even after taking it.
I would like to know the reason for this.
Can I go directly to the emergency room?

GG, 10~19 year old female. Ask Date: 2014/03/27

Dr. Lin Jixiong reply Cardiology

Hello, your situation is a bit special.
I recommend that you return to the outpatient clinic and discuss it with your cardiologist.
If you are feeling very distressed, it would be safer to go to the emergency department for evaluation.
Dr.
Lin Chi-Hsiung, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2014/03/27

More Info

When dealing with persistent heart pain, especially in the context of a known condition such as an atrial septal defect (ASD), it is crucial to understand the potential implications and when to seek emergency care. Your symptoms of recurrent chest pain lasting over a minute, accompanied by sweating and difficulty breathing, are concerning and warrant immediate medical attention.

Understanding Your Symptoms
1. Chest Pain: Chest pain can arise from various causes, including cardiac issues, gastrointestinal problems, or musculoskeletal pain. Given your history of ASD, it is essential to consider that your heart may not be functioning optimally, which could lead to symptoms like angina (chest pain due to reduced blood flow to the heart).

2. Shortness of Breath: This symptom, especially when combined with chest pain, can indicate that your heart is struggling to pump effectively. In patients with structural heart defects, such as ASD, the heart may become overworked, leading to heart failure or other complications.

3. Sweating and Anxiety: Excessive sweating and feelings of anxiety can accompany cardiac events. These symptoms may be your body's response to pain or distress, indicating that something is wrong.

When to Seek Emergency Care
You should seek emergency care if you experience any of the following:
- Persistent Chest Pain: If your chest pain lasts more than a few minutes or is severe, it is crucial to seek immediate medical attention.

- Difficulty Breathing: If you feel like you cannot catch your breath or are experiencing significant shortness of breath, this is a medical emergency.

- Sweating and Nausea: These can be signs of a heart attack, especially when combined with chest pain.

- Radiating Pain: If the pain spreads to your arms, back, neck, or jaw, this could indicate a serious cardiac issue.

Recommendations
1. Go to the Emergency Room: Given that your symptoms have persisted for three days and include significant discomfort, it is advisable to go to the emergency room. Do not wait for the pain to worsen or for additional symptoms to develop.

2. Inform Medical Staff of Your History: When you arrive at the hospital, inform the medical staff about your history of ASD and any medications you are currently taking. This information is vital for them to assess your condition accurately.

3. Follow-Up Care: After your emergency visit, ensure you follow up with your cardiologist. They may want to conduct further tests, such as an echocardiogram or stress test, to evaluate your heart's function and determine if any interventions are necessary.

Conclusion
In summary, your symptoms are concerning, especially given your existing heart condition. It is always better to err on the side of caution when it comes to heart health. Seek emergency care immediately, and ensure that you communicate all relevant medical history to the healthcare providers. Your health and safety are paramount, and timely intervention can make a significant difference in outcomes related to heart conditions.

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